Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.57 / $3,030.17 / $7,632.44	Facility		$157.57	$3,030.17	$7,632.44
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,043.00 / $4,043.00 / $4,043.00	Facility	50	$4,043.00	$4,043.00	$4,043.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $52.93 / $149.29 / $363.08	Facility	52	$52.93	$149.29	$363.08
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.17 / $59.72 / $145.22	Facility	53	$21.17	$59.72	$145.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.91 / $226.20 / $676.27	Professional		$98.91	$226.20	$676.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,691.00 / $3,333.00 / $4,636.00	Facility		$1,691.00	$3,333.00	$4,636.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $270.70 / $357.18 / $928.92	Professional		$270.70	$357.18	$928.92
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $156.82 / $156.82 / $4,050.00	Facility		$156.82	$156.82	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $156.82 / $156.82 / $461.91	Professional		$156.82	$156.82	$461.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $184.63 / $184.63 / $3,479.91	Facility		$184.63	$184.63	$3,479.91
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $147.69 / $147.69 / $147.69	Facility	52	$147.69	$147.69	$147.69
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $36.93 / $36.93 / $36.93	Facility	53	$36.93	$36.93	$36.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.13 / $340.89 / $1,028.28	Professional		$120.13	$340.89	$1,028.28
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $155.38 / $332.00	Facility		$90.00	$155.38	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $351.63 / $419.14 / $617.08	Professional		$351.63	$419.14	$617.08
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.81 / $419.45 / $601.74	Professional		$267.81	$419.45	$601.74
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $760.88 / $1,211.19 / $2,788.77	Facility		$760.88	$1,211.19	$2,788.77
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $15.00 / $15.00 / $1,812.62	Facility	50	$15.00	$15.00	$1,812.62
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $1,730.68 / $1,730.68 / $1,730.68	Facility	52	$1,730.68	$1,730.68	$1,730.68
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $184.63 / $555.00 / $3,479.91	Facility		$184.63	$555.00	$3,479.91
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $147.69 / $147.69 / $147.69	Facility	52	$147.69	$147.69	$147.69
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $36.93 / $36.93 / $36.93	Facility	53	$36.93	$36.93	$36.93
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $133.47 / $404.08 / $1,125.75	Professional		$133.47	$404.08	$1,125.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.00 / $3,496.00 / $5,963.00	Facility		$1,348.00	$3,496.00	$5,963.00
United Facility/Professional Professional Modifier Low / Median / High Price $260.87 / $397.90 / $1,023.60	Professional		$260.87	$397.90	$1,023.60
Univera Facility/Professional Facility Modifier Low / Median / High Price $116.90 / $116.90 / $225.00	Facility		$116.90	$116.90	$225.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $252.99 / $419.45 / $601.74	Professional		$252.99	$419.45	$601.74